Our Experts

Since last month, people over age 50 have been eligible to receive a second COVID-19 booster vaccine at least four months after their third shot to increase their protection against severe disease.

The recommendation came as the highly transmissible omicron BA.2 subvariant began to spread around the world, and as studies suggested that protection provided by the vaccines wanes over time, making older people more vulnerable to serious illness from COVID-19.

Immunocompromised people over 12 and anyone who received the Johnson & Johnson vaccine also are eligible for a second booster dose of either the Moderna or Pfizer/BioNTech vaccines.

Dr. Ray Carter, a primary care physician at ChristianaCare’s Concord Health Center in Chadds Ford, said his health system has seen an increased demand for second boosters over the past few weeks as concern for the new variant rises.

“We try not to make any decision for a one-size fits all approach. We take in consideration the patient’s wishes, of course, as well as their medical concerns, their medical problems, their history previously, how they’ve done well with previous vaccines and the like,” he said. “So I am, for the most part, very much following the CDC’s guidance for recommendations. But we’re certainly contextualizing and individualizing, because we know our patients best in terms of their medical history and care, and the patients need to be part of that decision as well.”

On this episode of Managed Care Cast, we speak with experts from ChristianaCare, which implemented a diabetes pilot program at 4 of its primary care sites in 2019 and saw its population of patients with well-controlled disease grow by 16%.

According to the CDC’s 2020 National Diabetes Statistics Report, 34.2 million Americans have diabetes, 88 million adults have prediabetes, and type 1 and type 2 are both increasing in incidence among younger individuals.

On this episode of Managed Care Cast, we speak with experts from ChristianaCare, one of the largest health care providers in the mid-Atlantic region, serving patients in Delaware and parts of Maryland, New Jersey, and Pennsylvania.

Hoping to increase the percentage of their patients with diabetes who have a hemoglobin A1C of 9% or lower, in 2019, ChristianaCare implemented a diabetes pilot program at 4 of its primary care sites, partnering each site with an endocrinologist and embedding a behavioral counselor at Primary Care Concord in Chadds Ford, Pennsylvania. With an original goal of growing this patient group by 10% by July of 2019, they instead saw 16% growth.

Marina V. Zeltser, MD, MBA, assistant chief medical information officer for population health and director of population health analytics at ChristianaCare; Raymond Carter, MD, clinical leader of primary care at Primary Care Concord; and Edward Feuer, MA, the behavioral health counselor embedded at Dr Carter’s practice sat down with us to discuss the pilot program, the team-based approach with results that exceeded

ChristianaCare’s original goals, and how they would like to see the program expand going forward.

WEST CHESTER – The flu season has officially just begun, and with so many people wearing masks because of the pandemic, many people are taking a relaxed attitude toward getting a flu shot this year.

But that’s not such a good idea, said Dr. Ray Carter, primary health care physician and pediatrician at ChristianaCare Primary Care Center at Concord Health Center.

“It’s super important this year for everyone to get a flu vaccine,” Carter said. “Masks are certainly a step in the right direction, but it’s just not good enough. We have a tried-and-true vaccine that works well with minimal risk that offers maximum benefits.”

Carter said that entering the holiday season, with more people indoors, the prevalence of the flu increases.

Make an appointment with your primary care physician to discuss your concerns, said Dr. Raymond Carter, pediatrician and primary care physician at Christiana Care Health System.

It is important to rule out any physical health issues and talk about any test results.

"If they are having serious or life-threatening complaints they should get in touch with a medical professional quickly," Carter said. "There's so much information out there and the sources aren't always reliable."

Carter said to think of doctors a "bridge" to help a patient.

"A good explanation does a good world of wonder to reduce someone's anxiety from the beginning."

If your anxiety does not dissipate after that initial discussion, talking to a mental health professional may help.

Dr. Ray Carter of ChristianaCare answers questions about vaccinations in Delaware.